# JOHANNA ELAINE KILLIAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114038700
- **Gender:** F
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 5601003414 | MI | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 02/25/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0A10115 | BCBSM GROUP | MI |
| 01 | — | 1531892018 | GROUP NPI | MI |
| 01 | — | CG9582 | PALMETTO GBA GROUP | MI |